Provider Demographics
NPI:1144906066
Name:BELTRAN PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BELTRAN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:407-518-9161
Mailing Address - Street 1:3214 HILLSDALE LANE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7562
Mailing Address - Country:US
Mailing Address - Phone:407-518-9161
Mailing Address - Fax:407-518-9942
Practice Address - Street 1:3214 HILLSDALE LANE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7562
Practice Address - Country:US
Practice Address - Phone:407-518-9161
Practice Address - Fax:407-518-9942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty